Conclusion
There appears to be no evidence of association between ACEIs/ARBs use
and a wide range of COVID-19 related clinical outcomes. However, good
quality evidence exists for ACEIs/ARBs and higher odds of
hospitalisation, lower odds of death/ICU admission (as composite
endpoint); but low-quality evidence for higher ICU admission, ventilator
use, hospital discharge and lower duration of hospital stay.
Furthermore, there are evidence, albeit of poor quality, of differences
between ACEIs and ARBs with the latter being associated with
significantly higher ICU admission but lower COVID-19 infection risk and
severity. Given the continuing controversial and paradoxical clinical
studies’ findings and hypotheses, we believe it is necessary to continue
to evaluate the effects of ACEIs/ARBs on COVID-19 clinical outcomes
especially as more randomised studies are reported.